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•��� � MUKILTEO WATER DISTRICT � <br /> SNOHOMISH COUNTY WASHINGTON ,� <br /> � � APPLICATION FOR WATER � Q <br /> • �0 � <br /> Application No. �� _y. . No. ' <br /> Meter Size l �� Number ot Units o2— Account No. _ �o� '/7.3�.�- I <br /> �-�� ., <br /> I hereby apply tor water service and agree 'o be governed in accordance with lhe resolutions, rules and reaulations oi the �� <br /> MUKILTEO W.4TER DISTRICT pertaining to water service, now or hereafler in ei(ect. The undersigned as owner or � <br /> representative o(the herein-described premises hereby agrees as lotlows: � <br /> U <br /> (t� That the cost ol any extension ol the walor sorvice,renewal, replacement or repair to roaeh and serve Ihe property descrihed shall be borne n <br /> 6y myself or assigns as ownm (s) of the pmmises. <br /> (2) That all pipos,water moasunng devices and olher connoctin�oquipment upstroam from tha moter shall,aRer their installation,6e and 6ecome <br /> the property ol the MUKILTEO WATER DISTRICT,suhject to all ils regulations pertaining to wa:er service. ` <br /> (3) Thataltarinstallation,ifmoterormelerboxnndappunencesaroburiedordamaged,thoowner,wili6eheldrosponsihleandchargodforsame. <br /> (4) ThatlheMUKILTEOWATERDISTRICT,itsotficersandagonts,shallhavethorighiolingrossendenrosstogouponthepremisesandpmperty <br /> describod herein lor tho purpose ol inspection,connocting or disconnecting tho sorvice or for such otner purposes as tho service may require. <br /> It is also understood during�he time that any ul the water mains may be oui of serviee by reason ol any emergency or impmvements authorized <br /> by the DISTRICT,in any street or other locauon in which Ihey may haw been laid,tho�ISTRICT wil;not be requirod ro fumish water during <br /> Iho progross of such improvemonts to any consumer whose supply mny Ihus bo cut otl,or ba Iia61e for any damages 1or its failure to do so. <br /> (5) Thnt tho DISTRICT sholl haw tho right to chango tho rates at any time by Resolulion,to tomporarily discontinue the sorvico to consumers,and <br /> �o install tha mmer(s) to rec�istor the water consumod. Tho DISTRICT shall not oe hold liablo for damage by water or other cause rosulting irom <br /> dofoctive plumhing or appliances instalied by tho ownor or occupant on the premisos supplied with water,and lhe tact thatagents of ihe D ISTRICT <br /> may hnve inspectod the plum6ing and appliances'shall not be plead as a basis for rocevery in ca;e of damage as aloresaid. II ihe supply of <br /> wa ter shall fail or be intertupted by reason af accident,low pressure or olher cause whntsoover,the DISTRICT shall not 6e held liable tor damagos <br /> nor shall such IaiWre or interruplion lor any roasonable timo be held to constirote a breach ot contract on the part ot Ihe DISTRICT or in any way <br /> � mliove the consumor,whether Ienant or ownor,Irom perioiming iha obligation ol such tenant's or owoer's eontruct. Water shall be usod by <br /> applicant only on tho pramises described h3rein. A new appliwoon shall bo lilea should wator bo dcsirod for other prei�iisos although Ixamd <br /> an land desvibed hcrein. t ,. <br /> iNt� 6) That the DISTflICT recommends Inslnlletlon ol e pressure reguleting valva. Applieant acknowledges Informatlon as to the <br /> �ecommendellon and assumes lull responslblllly lor Installing or felling to Inslall e pressure regutaling value on ihe weter system lo <br /> protect Il from high pressure. �� ' <br /> rvi (7) The DISTRICT u�ilizos check valves at tho meter to prevent woter reiurning to the Districts malns. The DISTflICT tecommends <br /> ins�alleuon of a ihermai expnnslon tnnk lo preven�excessive pressurobulld-up ceused by tho water heater. Appllcanis acknowledges <br /> � ^� Inlormellon as�to Ihe recommendnf(on and essume f�ll`rospo`n'siblity tor Installing or failing�o inslall e ihermal expension �enk. <br /> SERVICEADDRESS:� ���,/�� LOT�NO. � ���7 <br /> — �3i� '/ . / PLATNAME: <br /> CITY/STATFJZIP: � (�. �Y� . �J'K �DY LEGAL DESCRIPTION: <br /> OWNcR'S NAME: n �_�.�J-�� � _ <br /> OWNER'S ADDRESS: �� <br /> CIN/STATE2IP: L �L� L�� . <br /> The premises ar�,to bo used as a <br /> ��� INFORMATION LETTER-GAVE/SENT: D . � <br /> CHARGES: F_AID <br /> (1)Scrvicc installation&eonneclion diargc Sa�OO • O !� <br /> (2)Genoral Facilities wnn�ction charge 5 /{S'3���::o�g�� JUN 011993 <br /> �s�om�� s MUKILTEO WATER DI3TRICT <br /> Total amount receivGd with opplicaUon� 5 � �3 d• D v <br /> IT IS UNDERSTOOD[hat Ihis Application,althoughsiqnod,shall no�bo binding upon the MUKILTEO WATER DISTFICT un�il approvod by iho DISTRICT. <br /> I,the undersignod,owner(or repmsentative)ot Iho proputly descnbod nbove,do horeby make application lor installation ol a ��-inch � <br /> diammer water supply service connection,m,, ng appunenances, and all nocossary�abor at my ezpanses. - ;� <br /> Datcd this___) day ol � ,�g_�3 <br /> / / <br /> APPLICANTS SIGNATURE� "� �I <br /> � <br /> App�icant's Name (please pnnt): � � G ✓7� / <br /> _.. AppiicanCs Address and Phonc Num6ec�� '��- �G 33 y� C�/ �� <br /> APPROVED: G=L—�� �/1 ' �_���_ <br /> MUKILT TE DISTRICT <br /> BY� �7 - — — Dato: �� - <br /> � � i <br />